Having such research in a frequently read (and cited) journal like the JADA is problematic in many ways. Time and my attention span will not permit me to go into great depth into those issues, but I do want to present an outline of the article, how (while no doubt well-intentioned) bad science was constructed atop a foundation of worse science, why the JADA had no business publishing such nonsense, how our body of scientific knowledge was not advanced one iota by this piece, and why the American Dental Association sullies the concept of science based inquiry when it associates with pseudo- and pre-scientific woo.

Article Synopsis

This research, supported by the National Center for Complementary and Alternative Medicine (NCCAM), was authored by four Chiropractors, a PhD (all but one of whom are associated with the Palmer College of Chiropractic), two dentists, and an RN (the latter three associated with the University of Iowa College of Dentistry). Their stated goal was to “assess the feasibility of conducting a full-scale RCT to evaluate the effectiveness of AMCT (Activator Method Chiropractic Technique) for the treatment of patients with chronic myofascial TMD (Temporomandibular Disorder).” (Note: RCT = Randomized Controlled Trial) Their rationale was that since many TMDs “can become a chronic problem lasting several years, and patients receive little help from traditional forms of treatment”, perhaps complementary and alternative medicine (CAM) therapies should be considered.

Editor’s note: Here is another repost of an article Steve Hendry and I penned for the Science Based Medicine blog. It has been modified slightly from the original for clarity, punctuation, and new information. Enjoy. -HGR

Fear sells, and the media loves it. If it’s scary, no matter how tenuous the link or inconclusive the study, you are going to see it on the news. How many times over the years have you heard that your cell phone might give you brain cancer, even though it never turns out to be true? Once such a claim is made, however, it becomes lodged into the public’s psyche and is accepted as true (this is known as anchoring), even after refutations and retractions are published (see Wakefield, Andrew).

And so it is with x-rays. The latest scare du jour, a recent study out of Yale that claims to show a correlation between dental x-rays and intracranial meningioma — the most common brain tumor and usually benign — has been enjoying widespread attention in newspapers, on the interwebs, and on the evening news. We don’t know if it will be on Dr. Oz, because we can’t bring ourselves to watch that show, but we feel the chances are good. Other alt-medders will no doubt have collective woogasms over the story and will attempt to incite fear and mistrust into the doctor-patient relationship. In fact, the Mercola website wasted no time in weighing in:

While this study does not necessarily establish causation between dental X-rays and tumors, previous research has also implicated dental X-rays in the development of thyroid cancer, and research clearly shows this type of radiation is not harmless…

Typical alarmist fear-mongering. When has any health care professional claimed that radiation is harmless? This is not cutting edge research; Wilhelm Röntgen, the discoverer of x-rays in 1895 and winner of the Nobel Prize in 1901 for his research in the field, advocated the use of lead aprons for protection from the ionizing radiation way back when. Further, trying to lump one study linking dental x-rays to meningioma to another study linking them to thyroid cancer is taking quite the kitchen sink approach. But if there are multiple alleged possible potential theoretical adverse effects from our dental death rays, it must be true, right? Throw enough crap against the wall, and some of it just might stick.

Well, not so fast. We’re dentists, and unlike many knee-jerkers, we’ve actually read the study and would like to offer a little bit of insight into this before everyone panics. In fact, with respect to Letterman, we’d like to offer our Top Three Reasons Not To Panic:

1. The data is primarily anecdotal. The study authors reasoned that since actual data about people’s radiographic histories is hard to compile (people typically see multiple dentists over their lifetimes, and there is no central repository of radiographs taken), it would be acceptable for epidemiological purposes to simply interview people and ask them to recall what dental x-rays they’d had taken over the years since childhood. Claus et. al. claim that people show accurate and unbiased recall of their x-ray histories suitable for drawing inferences decades later, but we have news for you. It is standard procedure for us, as dentists, to ask new patients what sorts of radiographs they’ve had in the last fews years (we will typically ask your previous dentist for copies to avoid taking them needlessly) and you people are terrible at remembering this sort of thing. Except for people who haven’t seen a dentist at all in years, it’s actually a bit unusual for a patient to accurately tell us what and when their last dentist took, even in the previous couple of years. Based on our daily reality, the idea that patients can recall what radiographs they’d had since childhood with epidemiologically useful accuracy seems implausibly optimistic (and ludicrous), especially when considering that the sample population ranged from 20 years to 79 years old. This would require an accurate memory and reporting of radiographs taken as far back as the 1940’s and 1950’s in many cases, which we submit is not a valid assumption. Further, most patients don’t even know the difference between the variouls types of films taken, or the situations for which they are prescribed. In fact, the authors, to their credit, state:

Limitations of this study include the possibility of either under-reporting or over-reporting of dental x-rays by study participants. This is a difficult problem in epidemiology, because, unlike medical care, which (at least within cohorts of patients drawn from health maintenance organizations or similar entities) may be confirmed by a review of centralized medical records, dental care generally is obtained (even for a single individual) from numerous dentists, all of which are outside of a health maintenance organization or hospital-based setting, providing little opportunity for researchers to validate dental reports in a timely or cost-efficient manner. No national database of dental treatment exists within the United States; hence, researchers must rely on patient self-report, despite the potential for bias.

Let’s play a fun game. We’ll ask you, the astute and intelligent reader of the Prism Blog, to recall your dental x-ray history for your entire life. Can you recall the exact dates when a full series of radiographs were taken? What about a panelipse? Corrected tomograms? Cone beam films? Individual films called periapicals? What about bitewing x-rays?

How did you do?

Not very well, did you? Well, don’t feel badly; we’re dentists and we wouldn’t be able to recall our own radiographic history from memory even if threatened with homeopathic hemlock! Asking meningioma patients if they remember having x-rays, and comparing with the memories of people not preoccupied with having brain tumors, is not only inaccurate, but also raises the obvious possibility of reporting bias by the study participants. These types of interviews will only get you “JFK grassy knoll” types of responses – false memories, prompted by pointed researchers, often years (or decades) after the original event(s).

We are also concerned that the authors apparently did not survey for other potential confounding factors, such as tobacco history, diet, occupational exposures, etc., or if so, they were not disclosed in the paper. It might even be that having had dental x-rays is correlated with going to the dentist regularly, and that those people are also more likely to see a physician regularly and have a timely diagnosis of medical conditions like meningioma. Or perhaps people who live healthy lifestyles and thus have healthier teeth and gums require fewer dental x-rays over their lifetime. In this scenario, quantitative measurements of dental x-rays are an indirect indication of systemic health, and thus a lower meningioma risk. Who knows, but the point is that there are a myriad of risk factors not considered in this study, and the one variable they attempted to measure was vague and nebulous.

2. The results defy dose response expectations The Yale study reports that meningioma patients are twice as likely than controls subjects to remember ever having had a bitewing x-ray (the most common film used in dentistry), and that more frequent bitewings were associated with increased risk. So far so good. But they found no significant correlation with full mouth series radiographs — a set of 16-20 dental x-rays. Please note that a full series of dental radiographs includes 2-4 bitewings, then adds 14-18 more! The take home message, if this were valid, is that a couple of cavity detecting x-rays may give you a brain tumor, but if your dentist takes an extra dozen or so films instead, you’ll be fine. Dr. Alan Lurie, president of the American Academy of Oral and Maxillofacial Radiology, said “That inconsistency is impossible to understand to me”, and he has a good point. “I think it is a very flawed study,” Dr. Lurie went on to say. As reported in the ADA News:

He (Lurie) characterized at least one outcome of the study—reflected in a table that related meningioma risk to types of dental X-ray examination—as “radio-biologically impossible.”

Said Dr. Lurie, “They have a table, Table 2, in which they ask the question, ‘Ever had a bitewing,’ and the odds ratio risk from a bitewing ranges from 1.2 to 2.0, depending on the age group. Then they asked ‘Ever had full mouth’ series, and the odds ratio risk from a full mouth series ranged from 1.0 to 1.2.

“That is biologically not possible because the full mouth series has two to four bitewings plus another 10 to 16 periapicals. A full mouth series, just to round things off, is 20 intraoral X-rays of which two to four are bitewings. They are showing that one bitewing has 50 to 100 percent greater risk than a full mouth series that has multiple bitewings plus a bunch of other films.”Explaining this gross internal discrepancy is difficult, as the epidemiologic and statistical methods are widely accepted, Dr. Lurie said. He attributes the perceived discrepancy in the data to possible recall bias in the patients involved in the study.

The study also found no correlation with cone-beam CT scans, increasingly used in dental implant treatment and providing the highest x-ray dose of any dental radiograph.

3. Lost in the background. Claus et al. point out that dental x-rays are the most common source artificial source of ionizing radiation, which is true, but omit the fact that they are among the least significant quantitatively. Data published in 2009 in the journal Radiology, puts this nicely in perspective:

Take note: in the race to blast the most radiation through your brain, nature is falling a bit behind your hospital, but your dentist can’t get within 2 orders of magnitude of it. That’s why you never see a Superhero (or a Godzilla) mutating out of a dental office to save (or destroy) the world. While hospitals and Mother Nature have veritable radiation bazookas at their disposal, we have but pea shooters.

The reason your dentist is actually such a poor choice for suicide by brain tumor is related not to frequency (what the authors of the study focused on) but to dose. Particularly with current trends toward digital x-ray equipment (which exposes patients to significantly less radiation than film x-rays), the actual radiation dose in a dental x-ray might surprise you (data from the Health Physics Society and from Randall Munroe’s superb infographic):

Dose in microsieverts

Dental bitewing

5

Dental Panorex

10

Daily background radiation

10

Airplane flight NY-LA

40

Chest x-ray

100

Lumbar spine

1500

Intravenous pyelogram

3000

Whole-body CT scan

10,000

Coronary angiogram

20,000

We hope this will help you understand why we roll our eyes when a physician reporter on NBC tells the audience that they should be really be refusing x-rays at the dentist. This is dangerous advice coming from someone outside of their field of expertise.

Medical radiation aside, an important question remains: when we all get several hundred μSv of background ionizing radiation through our bodies and brains per year — every year- it seems a bit odd that an extra 10 μSv, even once in your life, would significantly raise your risk of anything to the degree that the Yale study claims.

And One More Thing. We are really getting a bit tired of hearing everyone who publishes or pontificates about x-rays opine sagely that x-rays should only be used where necessary, as if they have invented the concept of radiation hygiene. This implies that physicians and dentists routinely take unnecessary x-rays. But this is not a new idea. Keeping radiation exposure As Low As Reasonably Achievable is a cornerstone of diagnostic radiography, and has been for decades. It’s called the ALARA Principle, and it has been taught to everyone who uses x-rays in Medicine and Dentistry for ages. If you go to your dentist (or your physician) and announce that you don’t want any unnecessary x-rays he or she is NOT going to say “no problem — we never really needed the ones we used to take!”. If he or she is any good, chances are that radiographs are prescribed (and that really is the correct term) because the diagnostic benefits of the bitewing or the angiogram vastly outweigh the risks. It’s good to discuss this with your healthcare provider, but bear in mind that doing many invasive procedures (even as simple as fixing a cavity) without the benefit of adequate diagnostic radiographs is often regarded as malpractice, and for good reason.

And One More One More Thing. We have devoted most of this blog post pointing out some of the flaws of this study and how it may have adverse effects upon your dental health. We would be remiss, however, if we didn’t point out that the fallout from studies such as these rests squarely upon the shoulders of irresponsible reporting by the media. In a desperate battle for viewers/listeners/readers, these stories are belched to the public uncritically, with fear being the primary angle. Rarely is equal time given to rational responses, and sadly, the personalities who spout the loudest are often physicians contracted with the news networks. This is unfortunate for many reasons; among them being that 1) as doctors, they should know better; they should read the article themselves and be able to interpret it correctly, and 2) their opinion is held in high regard by the public, making our job of discussing it with our patients that much more difficult. We can’t tell you how often we have heard from our colleagues the fallout we’ve received when the Great and Powerful Woozard of Oz (a cardio-vascular surgeon) informed his disciples that one can effectively whiten one’s teeth with raisins and lemons. Not only is that patently false; it’s harmful to teeth, as putting something almost as corrosive as battery acid on one’s teeth is generally frowned upon in the dental community. Stories such as these can often create a wedge in the relationship we dentists try so hard to establish with our patients.

Finally, dentistry is by necessity somewhat more reliant on routine radiographs than other health professions because we deal primarily with hard tissues subject to diseases that are often invisible without some radiographs. Keep in mind that tooth decay and periodontal disease are among the most prevalent diseases of the human race, and early detection and treatment are critical to good oral and systemic health. Without radiographs, we often cannot see decay until it reaches the nerve and kills your tooth, or the impacted wisdom tooth until it has damaged the tooth next door, or the asymptomatic abscess until it puts you in the hospital. Occasionally, we discover pathological processes, including the rare case of oral cancer long before they would manifest clinically. A timely x-ray, even in someone with no symptoms, could save a life. We as a profession readily accept the radiation burden in a bitewing or full mouth exam because of the obvious benefits for the well being of our patients. When we order any X-ray exam, we have made the determination that the benefit outweighs the risk and the risk of such exams are much less than those risks we commonly accept in daily life. We do not take this responsibility lightly.

So, do dental x-rays cause meningiomas? We have criticized the original article and the reporting thereof, but the fact remains that we don’t know. They might, of course, but unfortunately the article only gives us a smattering of data, obtained from a sloppy study, that may or may not be relevant. The signal to noise ratio contained in this study was too low to be of much use, and it’s hard to understand how higher-dose x-ray exams could be safer than the lower dosed single bitewings, or why far higher doses from other sources would not contribute to the same problem. Hopefully a more thorough study will be done to add to our body of knowledge and either confirm or refute the findings of the original article.

Yes folks, you heard right! Three. Minute. Orthodontics. Why spend thousands of dollars and years of aggravation with braces, palatal expanders, retainers, cut cheeks, and social isolation when you can correct your overbite in three minutes?

How, you might ask? With all the scientific advances in orthodontic treatment in the past 100 years, with the improvement in imaging, diagnosis, and the amazing materials we have these days- how can we push the envelope even further in orthodontics?

Well, I’ll tell you.

According to the video you’re about to see, “Dental Acupuncture is a special branch of acupuncture. Asthetic Dental Acupuncture is a Super Specialty.” So, dear Prism readers, I hope you feel like a priviliged insider because you’re about to see a “Super Specialist” at work. You can’t get this anywhere else. I’ve been practicing dentistry for over 27 years, and I have studied with some of the finest and most prestigious clinical dentists in academia and in practice, and I have never had the good fortune to even touch the hem of a “Super Specialist’s” garment. So, I hope you’ll excuse my giddiness.

Anyway, many of you may remember the scene from the movie “There’s Something About Mary” in which the hitchhiker, played by comedian Harland Williams, talks about the next big thing – Seven Minute Abs. Watch.

Well, that same “outside the box” thinking has hit dentistry, thanks to a pair of Indian “Super Specialists.” The video below show a case report of an overbite allegedly being corrected by “asthetic acupuncture.” Warning: It’s a little graphic in a stabby, bleedy sort of way.

So there you have it.

Ok, joking aside. I realize that this is a fringe treatment in a far-off land, at least far off from where I’m composing this post. I also realize that this treatment isn’t widespread, nor is it likely to become so. It’s quackery, pure and simple. It’s about as far away from the standard of care as a dental procedure can get. It’s funny because even a non-dentist, nay, even any person with a modicum of science knowledge or common sense can see this is bunk and ludicrous and biologically implausible and every other hyperbolic refuting description one can think of. That being said, it is an excellent example of why we at The Prism do what we do. There are quacks like that out there. Not only in India, but everywhere. There are innocent and gullible individuals who fall prey to such quacks. Not only in India, but everywhere. The quacks need to be stopped and the laypeople need to be educated; it’s as simple as that. The public is harmed when charlatans like this are allowed to deceive the patients who entrust them for their care. Whether you’re an activist trying to shut this crap down, or an educated health care professional, or a concerned resident of Planet Earth, we all must resist woo in all its forms and wherever it rears its ugly head. Even if it seems harmless, the underlying deception and denial of reality hurts everyone.

Surely by now you’ve read the story about the dentist who bought John Lennon’s decayed molar at auction and now plans to extract DNA from it and clone the late, great Beatle. You’ve seen the clever headlines (the best of which was from Sharon Hill: Just Like Starting Over, With Another John Lennon), and the lame attempts at humor (admittedly I’m guilty of this):

— I’m fixing a hole where decay gets in…

— Imagingivitis

— I wanna clone your hand…

— You should see Polydent Pam…

— I cloned a tooth today, oh boy…

I’m here all week. Tip your waitress.

Yes, I know I’m behind the curve on this story, as it jumped the shark last week. However, as a dentist I feel it is my odontological duty to cobble together at least a half-assed blog post so that I don’t have to go stand by myself in shame at blog author parties. So here goes.

To summarize, in 2011 a Canadian dentist named Michael Zuk purchased one of John Lennon’s extracted teeth for around $31,200. By the looks of it, it needed to come out- a huge carious lesion (cavity) encompassed almost half of the tooth.

Ewwww.

While perhaps a bit eccentric and macabre, a dentist wanting to own a tooth that used to belong to perhaps the most famous rock musician in history is not that unthinkable; heck, I’d take it in a heartbeat. In fact, if I owned Lennon’s tooth, I’d parade it around like it was the fricking Magna Carta. But where it gets weird is that Dr. Zuk now has plans to extract the DNA from the molar and attempt to clone a brand-spanking-new John Lennon.

“I am nervous and excited at the possibility that we will be able to fully sequence John Lennon’s DNA, very soon I hope,” Zuk said in a statement on his John Lennon Tooth site. “With researchers working on ways to clone mammoths, the same technology certainly could make human cloning a reality.”

(Editors note: John’s hair style in the mid-1960s when this tooth was extracted resembled a wooly mammoth’s. Coincidence?)

OK, let’s get this out right at the beginning of the post so as not to create confusion or give Dr. Zuk more scientific credibility than he deserves. This is a publicity stunt, pure and simple. I’m sure Dr. Zuk is a fine man and an excellent dentist, but he is milking this thing for all it is worth. And I’m not blaming him or criticizing him at all; I’m just pointing this out so that no one gets the weird idea that there might soon be another John “Dolly” Lennon roaming the streets, gearing up for British Invasion v2.0. Ignoring for a moment the probable insurmountable biochemical challenges in extracting, amplifying, and actually cloning John’s DNA (not to mention the expense); one also has to consider the little things such as ethics, legal battles, ownership disputes, and so on. It ain’t gonna happen, folks. Michael Zuk will get his fifteen minutes of fame (which is equal to about eight Beatles songs), and he will somehow, some way get more than $31,200 worth of milage and publicity out of it. Consider it a smart and savvy marketing move on his part and good on him. I wish him the best.

But suppose Dr. Zuk couldovercome said obstacles. Suppose he owns a private island in the middle of the Pacific Ocean beyond the reach of any scientific or legal body, with the world’s best scientists and the latest technology and equipment at his disposal. How would he go about cloning “The Smart Beatle” (remember, George was the shy one, Paul was the cute one, Ringo was the sad one, and Pete Best was the colossal idiot one)? Here is a step by step, very basic primer on the cloning process of creating a John Lennon:

1. Relatively large, undamaged strands of DNA must be isolated and extracted from the pulp chamber (i.e. nerve) of the tooth. Historically, pulp chambers of animals are excellent reservoirs of genetic material due to the protection of the hard enamel. In John’s case, the pulp chamber would have been invaded by bacteria in the huge cavity, rendering it contaminated. Note: as cloning technology improves, complete strands of DNA will be able to be synthesized from a lot of smaller snippets; further, techniques for separating human DNA from bacterial or other contaminating DNA will improve as well.

2. OK, let’s say we were able to cobble together various chunks and we now have a full, intact strand of John’s DNA. Now what? Now we must make copies of this DNA. Using the Polymerase Chain Reaction (PCR) technique, the enzyme polymerase makes exact copies of the original strand(s) of DNA.

3. The next step is transfection, in which the scientist inserts the copied DNA into a host cell, often a cell from which the existing DNA has been removed.

4. Then there is some hocus pocus, hand waving, maybe a smoke bomb or two (actually they run a current through it and do other things), and the cell with the DNA is implanted into the surrogate with conventional IVF techniques.

(Disclaimer: I’m not a cloning expert, and I’m sure my simplistic explanation above is fraught with errors. But for our purposes, it gives a broad overview of how cloning occurs. Please forgive any mistakes on my part, and if you want to point them out on the comments page or by emailing me at feedback(at)prismpodcast.com, I’d appreciate it.)

So there you have it: a fun romp through music history and biotechnology.

I just hope that if and when this cloning feat occurs, science will have advanced enough so that the gene that was responsible for the abomination that is the “song” John and Yoko can be excised and forever destroyed. What’s up with that? YOU WERE A BEATLE, FOR CHRIST’S SAKE!!

I can hardly wait,To see (cloning) come of age,But I guess we’ll both,Just have to be patient,Yes it’s a long way to go…

Believe it or not, there are podcasts out there that are even better than the one Jason and I did a couple of weeks ago (#sarcasm). Among the many fine choices out there, RadioLab is consistently excellent and intriguing; it is invariably at the top of my listening queue. Recently, RadioLab did a show on a patient who survived rabies, which until recently was 100% fatal- a death sentence with no chance of commutation or reprieve from the Governor. The story itself is amazing, and you should stop reading here, take a brief intermission and go listen to it. I’ll be here when you get back.

OK, back? Pretty good, huh? Though I was transfixed during the entire episode, do you know what little tidbit of information stuck with me more than anything else? The off the cuff factoid that back in medieval times, one of the treatments for rabies was to pluck the feathers from around a rooster’s anus, then apply said anus to the animal bite, ostensibly to “suck out” the infection. Makes sense, eh? I mean, I’m no rooster anus aficionado, but I can imagine that it might resemble a suction cup sort of thing. These are some pretty weird dots to connect to be sure, but I guess that when faced with a potentially fatal disease, physicians back then tried anything and everything hoping to find that magical cure, even if by luck or trial and error. Without the scientific method, that’s pretty much all they had.

Why, I can hear you ask, whywould tincture of tush even continue as a recommended treatment after the first attempt or two? OK, I’ll give the doctor/barber/blacksmith the benefit of the doubt when thinking of it for the first time and giving it a go, but then after that? How could the doctor of yesteryear think this was a good idea? Did his success rate in treatment skyrocket after sphinctotherapy? How does one rationalize this?

Well, here’s how it went down, and the reason I’m bringing this up isn’t just because it’s a fun, quirky subject or that I have a thing about poultry and/or anuses. There are modern day applications of this same dysfunctional thought process, and the public must be made aware of these modern day purveyors of rooster anus therapies and their likes.

Suppose you’re this guy, the village doctor:

A frantic mother comes running into your office/stables with her 12 year old daughter in tow. The young girl has just been bitten by a mad dog and everyone knows what that means. Thinking quickly, you grab a rooster, pluck the feathers from around its anus (I’m sure there’s an insurance code for that), and apply buttsuction pressure to the wound stat. You then write a prescription to the mother like so:

After a week, you go and check up on the family; lo and behold! the girl is fine. No signs of rabies and the wound is healing well. When you get back to your office/stables, you look back over your notes and determine that your avian treatment protocol has roughly a 25% success rate. “That’s pretty good” you say. “If it weren’t for my quick thinking and medical acumen, they all would have died. This modern treatment of rabies is proof that we have truly made great advances in medical science. In my experience, rooster anus is the treatment of choice for rabies.”

So what is the reality here? Do sphincters possess medicative qualities? Was Yorick the doctor/barber/blacksmith on the right track?

No and no.

The reality is that while rabies is a horrible disease, it is only 100% (well, until recently at least) fatal once it has established a foothold in the host. Often, a person who is bitten by a wild animal doesn’t contract rabies at all. There are several possible explanations for this: 1. the animal didn’t have rabies to start with, 2. the bite didn’t break the skin, 3. the virus didn’t enter the bloodstream or other area where it could take up residence in the nerve tissue, or 4. the victim’s antibodies dispatched the viruses before they could cause harm.

There could be other explanations and scenarios, but you get the picture. While all rabies infections were 100% fatal, not all animal bites were. Dr. Yorick, of course, wasn’t aware of all the times a person was bit who subsequently remained healthy. His experimental group, as it were, consisted only of those who either had been bitten but not yet showed the signs of rabies or people with full-fledged rabies. The former group would naturally respond reasonably well to Rooster Anus Therapy®, not because of the rooster, but because that person stood a decent chance of remaining healthy anyway. Yorick naturally would take credit for the health of this subgroup. This fallacy in reasoning is called Post Hoc, Ergo Propter Hoc, which is similar to Affirming the Consequent. The logical structure goes something like this: P occured before Q. Q resulted, therefore P caused Q. Translated, this reads “If I put a rooster’s anus onto an animal bite, the patient will not contract rabies. The patient did not contract rabies. Therefore, rooster anus is effective and prevented the rabies.” This is where Yorick went wrong and relied only upon his experience, but you can’t blame the chap.

You can, however, blame the frauds, quacks, and ignorant practitioners of woo out there who peddle their own version of rooster anuses to a gullible and unsuspecting public. From homeopathy to acupuncture, to just about every kind of “complementary” or “integrative” therapies, they all work on the same Affirming the Consequent principle. You pressed, poked, stabbed, or shocked some alleged point on your body and your knee pain felt better? You swallowed a supplement and you slept better last night? You pressed a rooster anus to your squirrel bite and you didn’t get rabies? The delusional practitioner will think “In my experience, ________ has worked well.” This is very dangerous thinking.

Modern day alt-med thinking and medieval rooster thinking is pretty much the same thing.

Most health care practitioners worth their salt know this; however, a vast number of lay people, as well as many other health care providers either don’t know it or choose to ignore it because of some bias or agenda. Or perhaps they are outright charletans. However, it is the responsibility of every science minded individual to fight this type of thinking and challenge these dysfunctional practices wherever they occur.